Download quick GUIDE

quick
GUIDE
Contents
User log in
New user
Registered user
Input new patient details
Quickstart
Opening an existing patient
Recording pulmonary flow after an aortic acquisition
Recording aortic flow after a pulmonary acquisition
Optimisation features
Mode, Volume, Gain, Contrast
Scale and Zoom
Add notes
FlowTracer automatic measurement
Trace
Measurement settings
TouchPoint manual measurement
Systemic vascular resistance
Reviewing exams
Trending
Setup
Reports
Screenshots
Exporting spreadsheets
Networking and printing
Networking
Printing
Printers
System backup
Backup
Restore
System shutdown
Cleaning
Unit
Transducer
The measure of life.
USER login
Touch blue ON button.
New User
Touch LOG IN.
New User Login.
Type in User Name and Password.
Confirm Password.
Touch OK.
Registered User
Touch LOG IN.
Type in Location, User Name
and Password.
Touch OK.
2
The measure of life.
INPUT new patient details
Touch NEW PATIENT.
Type NAME and/or PATIENT ID.
A Patient NAME or ID is a required field.
Select DATE OF BIRTH.
Select AORTIC or PULMONARY.
Type HEIGHT and WEIGHT.
To override the OTD with an echocardiogram
OTD measurement:
Touch the Measured box.
Select OTD from the list.
Touch GENDER.
Type Operator.
Touch OK.
You are now ready to begin an acquisition!
The measure of life.
3
QUICKSTART
RUN activates the QUICKSTART feature, this allows
direct access to the Examination screen without the
need to enter a patient’s details first.
The Doppler trace will start automatically.
Touch RUN
When a profile is selected, measures that do not require
the height and weight will display.
Touch the measure card to display calculated measures.
Enter the patient’s height and weight. Select Aortic or
Pulmonary OTD.
Touch OK
To SAVE the exam a Login is required.
Touch SAVE
4
The measure of life.
QUICKSTART cont.
Enter User Log in details.
Save to an existing Patient by touching the Patient name.
Touch the NEW button to create a new patient.
As previous details have already been added,
Name or patient ID is all that is required.
When the measure has been saved additional measures
can be saved.
The measure of life.
5
OPENING an existing patient
If the patient details have previously been entered
Touch OPEN.
Double click Patient name
or
Select Patient name and touch OK.
To review existing exam data
Double click EXAM date
or
Select Exam date and touch OK.
To select a new Exam select NEW
Confirm Patient Details.
Select AORTIC or PULMONARY.
Confirm OPERATOR.
Touch OK.
Touch START
You are now ready to begin an acquisition!
6
The measure of life.
RECORDING PULMONARY FLOW after an aortic acquisition
To record both aortic and pulmonary profiles on the same exam:
Change from an aortic, positive signal to
a pulmonary, negative signal.
Touch the Y- axis.
Touch 0 on the Scale.
The scale will invert and the Mode will change
from AV to PV.
Touch OK.
To record pulmonary profiles as a new exam:
Refer to Opening an existing patient.
On the Patient Details page,
Select Pulmonary OTD.
Touch OK.
The measure of life.
7
RECORDING AORTIC FLOW after a pulmonary acquisition
To record both aortic and pulmonary profiles on the same exam:
Change from a negative, pulmonary signal to a positive,
aortic signal.
Touch the Y- axis.
Touch 0 on the Scale.
The scale will invert and the Mode will change from PV to AV.
Touch OK.
To record aortic profiles as a new exam:
Refer to Opening an existing patient.
Go to Patient Details page.
Select Aortic OTD.
Touch OK.
8
The measure of life.
OPTIMISATION features
Touch the COGWHEEL symbol
to access the CONTROL PANEL.
Mode
Only used when changing from pulmonary to aortic with the apical access.
Touch AV.
Note: When changing from aortic SSN access, to pulmonary left intercostal space access, touch on
the Y- axis of the velocity graph and touch ‘0’ on the scale.
Volume
Audio is an integral part of acquiring a Doppler profile.
Use VOLUME to receive better audio feedback.
Touch the desired number.
Gain
Increases the strength of the returning signal.
Use GAIN to delineate the edges of the profile.
Touch the desired number.
Contrast
Defines the trace compared to background noise.
Use CONTRAST to clarify the signal.
Touch the desired number.
The measure of life.
9
OPTIMISATION features cont.
To access scale and zoom
Touch the Y- Axis.
Scale
Touch the velocity on the scale bar that best displays
the Doppler flow profile.
Touch OK.
Incorrect scale
Inability to determine if the peak of the
Doppler profile has been achieved.
Correct scale
Doppler profile peak is determined.
10
The measure of life.
OPTIMISATION features cont.
Zoom
Change ZOOM to view more or less profiles per screen.
Doppler flow profiles at 1.0X
Touch 0.5X to view more profiles.
Touch 2.0X to view Doppler profiles when a very fast heart
Rate is present.
Touch OK.
The measure of life.
11
ADD Notes
USCOM or PATIENT TABS
Touch NOTES.
Touch ADD.
Type notes to document changes
in interventions, fluids or medications.
Touch OK.
A date and time stamp will be attached
automatically.
Touch Back.
Notes on Trend Screen
A note icon will display on the trend screen header aligned with the Exam time.
Touch the note icon to display the Notes contents.
12
The measure of life.
FLOWTRACER automatic MEASUREMENT
The FlowTracer feature automatically traces the edge of the Doppler flow profile displayed on the
examination screen. This provides automatic measurement of the displayed profiles.
FlowTracer’s red trace line is automatically displayed.
Touch SAVE, to store the profiles’ measurements.
Trace
When the trace is active, the red line may be removed by
touching the Trace button
Note: FlowTracer measurements will continue to be displayed.
Measure flow profiles from ‘highest’ peak velocity to
‘lowest’ peak velocity, allowing for a respiratory cycle.
Measure 5 profiles for sinus rhythm (a minimum of 5).
Measure 5-10 profiles for atrial fibrillation.
If correction of the trace line is needed, use TouchPoint.
(Refer to TouchPoint Manual Measurement)
Measurement Settings
Touch the Cogwheel symbol.
SELECT options
There are 3 choices for selecting Doppler flow profiles:
One: One flow profile is selected and saved to a measure
card. This allows ‘one by one’ saving of profiles.
All: All valid flow profiles are selected and each Doppler
profile is saved as a separate measure card.
This allows for all profiles to be rapidly saved.
Group: Valid profiles are selected and grouped into a single
card. The value’s average, of the group of selected profiles,
is displayed as the Measure Card.
The measure of life.
13
FLOWTRACER automatic MEASUREMENT cont.
One:
One valid profile will be traced.
Touch ONE
Touch OK
Touch Freeze when a screen of profiles is acquired.
Touch the desired Doppler profile.
Touch SAVE
All:
All valid profiles will be traced.
The values of the last valid profile will be displayed
on the Measure Card.
Touch ALL
Touch OK
Touch Save.
Each Doppler profile’s values will be displayed on a separate
Measure Card and displayed on the trend graph.
Recommended for use in research, where acquisition time is
limited and hemodynamic information is not immediately
needed .
Group:
All valid profiles will be traced and selected.
A profile can be deselected by touching that profile.
Selected profiles have a V peak marker.
Touch GRP
Touch OK
One Measure Card only will display the average value of the
selected profiles in the group.
The trend change from the previous card can be displayed.
Touch Save.
Recommended for use in clinical situations.
14
The measure of life.
TOUCHPOINT manual MEASUREMENT
FlowTracer FT is the system default.
To activate TouchPoint touch TP on the Control panel.
Touch OK.
Set the TouchPoint Handles to completely envelope
the flow profile.
Measure flow profiles from ‘highest’ peak velocity
to ‘lowest’ peak velocity, allowing for a respiratory cycle.
Measure 3-5 profiles for sinus rhythm.
Measure 5-10 profiles for atrial fibrillation.
When in GRP SELECT mode, multiple TouchPoint profiles
may be saved. The average value for this acquisition may be
found on the trending screen.
Note: Reselect FlowTracer (FT) and GRP before the next
acquisition.
Note: Tap to move the TouchPoint profile tracing along the
side of the Doppler profile to the left.
Drag Handle 1 to move the TouchPoint profile tracing to the right.
Start by placing the TouchPoint profile tracing at the position of valve opening but not on the edge of
it.
Set Handle 1 here.
Note: Place on valve opening ‘click’ if identifiable.
Set Handle 3 at the Doppler flow above the profile peak.
Making sure all the profile is contained within the red triangle.
This is a higher position than where FlowTracer will trace the
peak.
Set Handles 2 and 4 on either side of the Doppler flow
profile.
Note: The Handles on the sides cannot be wider than the
Handles at the base.
Set Handle 5 at the point of valve closure.
Note: Place on valve closing ‘click’ if identifiable.
Set Handle 6 at the valve opening of the next cycle.
Note: Place on the valve opening ‘click’ if identifiable.
Confirm the ‘vertical guidelines’ of Handle 1 and 6 are an
equal distance from the corresponding
Doppler flow profile.
Touch SAVE.
Note: Re-activate FT before next acquisition.
The measure of life.
15
SYSTEMIC vascular RESISTANCE
Manual input of blood pressure is required.
Touch a Doppler flow profile.
Touch SVR on the Measure Card.
The SVR panel will open.
Using the ENTRY TAB enter BPSys and BPDia
or MAP.
If CVP is not entered, the value will be ‘0’.
SVR is displayed in the Measurement Card.
Touch OK.
Active BP
BP values stay active for 10 mins after the
first profile has been saved.
The values display in black.
Expired BP
Expired BP values will display in blue.
Access SVR control panel,
enter new BPSys and BPDia or MAP values
or touch OK to confirm existing values.
Entering BP After Profile Save Or Resave
When a Doppler profile is saved or resaved, all other profile cards within that acquisition are also
resaved with the same BP values (SBP, DBP, MAP and CVP).
The SVR value for each profile card is recalculated using the new values.
For example, if Doppler flow profiles are acquired and 5 are selected and saved before the BP values
have been entered, enter the BP values on the last Doppler flow profile of the acquisition and all 5
cards will be automatically updated with the entered BP values.
In REVIEW mode, enter BP values on any profile card and all 5 cards will be automatically updated
with the entered BP values.
16
The measure of life.
REVIEWING exams
Touch OPEN.
‘Double click’ Patient name
or
Select Patient name and touch OK.
‘Double click’ Exam Date
or
Select Exam Date and touch OK.
USCOM TAB
Review profiles and measures on Examination screen.
Touch the MEASURE CARD NUMBER
to review a saved profile or profiles.
To RE-MEASURE, reposition the profile trace line using
TouchPoint.
(Refer to TouchPoint Manual Measurement)
Touch RE-SAVE.
To create a New exam
Touch NEW EXAM
TREND TAB
Review trending of up to four parameters including notes
The measure of life.
17
REVIEWING exams cont.
Touch the USCOM logo to review an exam of a
different date or time.
’Double click’ Exam Date
or
Select Exam Date and touch OK.
.
To return to other exam dates,
touch the USCOM logo in the Examination
screen
PATIENT TAB
Touch the Patient tab to review trending and history.
The patient’s previous examinations will be listed.
Touch HISTORY and a graph of the average value of
each exam will be displayed.
Touch TREND and a graph of each card value
of the selected exam will be displayed.
In Patient tab, touch the USCOM logo to return
to the Welcome screen.
Touch the USCOM tab to return to the
Examination screen and profiles.
18
The measure of life.
TRENDING
USCOM TAB
The current trended parameter is SV.
To display a different parameter on the graph, touch the
trend graph header. The parameter Pop Up will appear.
To choose a different parameter, touch that parameter in
the Pop Up.
TREND TAB
Trending of 2, 3 or 4 measures can be displayed.
Graph
Card Data Points
Red - Aortic values
Blue - Pulmonary values
Circle
Square
Triangle
- FlowTracer in GROUP mode
- FlowTracer in ONE / ALL mode
- TouchPoint in ONE mode
Exam Marker (blue dashed line) indicates the start of a new exam.
Selected Card Marker (red arrow and dashed line) indicates the selected date and time of the
selected card. The value for this card is prominently displayed under the Measure Select button.
Notes
Touch the Note icon above the graphs to display the content detail.
Scale
To optimise the scale, touch the scale.
If there is a data point out of range, this will be indicated by an arrow in the scale display.
The horizontal axis represents time and has a range from seconds to years.
Broken Time can be selected to remove ‘non active’ time periods.
Zoom / Reduce time scale
Use +/- button (Zoom will centre on the red Selected Card Marker)
Or
slide the stylus across the graph
Move Forward / Backward in time:
Use Left or Right arrows
Or
double click on the card of interest to centre it
The measure of life.
19
TRENDING cont.
Measures
To change the displayed parameter, touch the Measure
Select button. The parameter Pop Up will appear.
To choose a different parameter, touch that parameter in
the Pop Up.
Measure Value Display
The prominently displayed value under the Measure Select
button is the Measured Value of the selected card.
The average value, (Avg) is the average of all card data points currently displayed on the graph.
Setup
Touch the SETUP button to open the Setup
dialog.
Delta
To display the calculated change select
from OFF, Δ (delta) or Δ (delta) %.
+/- Percent Change
To display a band highlighting the percent or percent difference between card data points select
from OFF, 5%, 10%, 15% or 20%.
Time
Absolute or relative time may be displayed by selecting N or Y.
Mode
Choose AV, PV or AV PV data points to be displayed.
Values
To display all, some or no Values, select from NONE, SEL or ALL.
Clustering
Values for Card Data Points will be displayed per card unless there is more than one card in a
relatively close point in time i.e. clustering of cards. In this case an averaged value for the cluster
will be displayed.
Note: When the averaged value for a cluster is displayed it will differ from the Measure Value of
the selected card marked.
Print / Screenshot
Touch PRINT.
Print
If a printer is connected the screen will be printed.
The first time a print is performed a dialog box will be displayed. If the required options are correct,
Touch OK.
Screenshot
If a USB drive / Flashstick is inserted into the USB port located on the back panel of the system
the displayed screen will be copied into a folder named ’Screenshots’ on the USB drive.
The file can be transferred to a PC.
Note: the patient details will replace the bottom panel buttons.
20
The measure of life.
REPORTS
USCOM or PATIENT TABS
Touch REPORTS.
Touch Card, Exam or Patient Report.
Touch Preview.
Insert a USB drive / Flashstick into the USB
port located on the back panel of the system.
Touch SAVE.
The report will be copied into a folder
named ‘Reports’ on the USB drive.
The file can be transferred to a PC.
Touch CLOSE.
The measure of life.
21
SCREENSHOTS
USCOM, TREND and PATIENT TABS
Insert a USB Flashstick into the USB
port located at the rear of the USCOM.
Touch PRINT.
The displayed screen will be copied into a folder
named ’Screenshots’ on the USB drive.
The file can be transferred to a personal computer.
EXPORTING spreadsheets
Touch USCOM on WELCOME screen.
Touch right arrow until the EXPORT tab appears.
Touch EXPORT tab.
Touch Patient Name or ID.
Insert a USB Flashstick into the USB
port on the back panel of the system.
Touch SAVE or SAVE ALL
Patient data will be copied, in spreadsheet format,
into a folder named ‘Exports’ on the USB drive.
The file can be transferred to a PC.
Touch OK.
22
The measure of life.
NETWORKING and PRINTING
Networking
The USCOM can be networked for printing of Screenshots, Reports, Notes and Spreadsheets.
(For Networking settings, refer to Settings in the USCOM 1A User Manual.)
Printing
From the Examination screen touch
the PRINT button.
If this is the first time printing has occurred a dialog
box is displayed to configure the print settings.
Change the settings to your preference.
Touch OK. The screen will be printed.
Printers
The USCOM 1A supports the PCL printer language.
HP supports the PCL language in their DeskJet and LaserJet printer range.
To determine if your HP printer uses the PCL language, refer to the printer
specifications on the HP website.
Note: To print using a USB printer, connect the printer to the USCOM 1A USB port.
To print to a network printer, it must be configured as a Microsoft Windows shared printer.
(For more information refer to Printer Settings in the USCOM 1A User Manual.)
The measure of life.
23
SYSTEM backup
Backup allows patient data to be stored offline and downloaded onto another USCOM system.
It is recommended to Backup regularly and often onto a USB Flashstick.
The file format is Microsoft compact database and is not readable on a personal computer.
Touch the USCOM button on the Welcome screen.
On the tabbed header touch the right arrow until the
BACKUP Tab appears.
Backup
Insert a USB Flashstick into the USB port located at the rear
of the USCOM.
Touch BACKUP.
The Users Patient Data will be backed up into a folder
named ’Backups’ on the USB Flashstick.
Restore
Insert a USB Flashstick, with previously backed
up USCOM data, into the USB port at the rear of the
USCOM.
Touch REFRESH.
Select the backup file you wish to restore and touch RESTORE.
The patient data will be restored onto an USCOM system.
Note: All Patient Data for the User will be overwritten.
Touch OK.
SYSTEM shutdown
From the Welcome screen touch OFF.
Touch OK.
24
The measure of life.
CLEANING
Unit
The USCOM must be turned off and unplugged from the
power pack.
Do not spill or spray water on the display or transducer
connector.
Wipe display and cables with a cloth moistened with
mild liquid soap and water.
Do not use harsh or abrasive detergents or solvents.
Do not clean with abrasive pads.
Do not wet or immerse the USCOM.
Transducer
After completely cleaning the transducer head from gel and any foreign
matter, the USCOM transducers and cables (not the connector) can be
disinfected by submersing the head for up to 15 minutes in 0.55%
orthophthalaldehyde (CIDEX OPA).
DO NOT submerse the connector.
The measure of life.
25
Quick Guide
Illustration Jam Graphics
Revision 1.8.0.0
Published January 2009
© Uscom Ltd.
This reference guide is provided as a service to medical personnel by Uscom Ltd. The information in this guide has been compiled
from available literature. Although every effort has been made to report faithfully the information, the authors and publisher cannot be
held responsible for the correctness. This guide is not intended to be and should not be construed as medical advice. The USCOM
1A provides relative information on haemodynamic parameters, absolute values depend on individual patient characteristics and
operator inputs. Values are for information only; all diagnostic decisions should be made by qualified persons based on their own
observations. Before any use, the product information guides, inserts and operation manuals of the various drugs and devices should
be consulted. It is the responsibility of the licensed prescriber, relying on experience and knowledge of the patient, to determine
dosages and the best treatment for each individual patient.
Uscom Ltd, nor the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising directly
or indirectly from the use of drugs, devices, techniques or procedures described in this reference guide. Uscom Ltd reserves the right
to revise the contents of this reference guide without obligation to notify any person of such changes.
The information presented in this reference guide is proprietary and is supplied on the understanding that it is employed for user
reference only. No part of this reference guide may be reproduced, transmitted, transcribed, stored in an information retrieval system,
or translated into any language, in any form or by any means, electronic, mechanical, magnetic, optical, chemical, manual, or
otherwise, without the prior written consent of Uscom Ltd., Level 7, 10 Loftus Street, Sydney, 2000, NSW, Australia.
Trademarks.
Brand and product names are trademarks or registered trademarks or their respective owners.
Copyright Uscom Ltd
Suite 1, Level 7, 10 Loftus Street
Sydney NSW 2000 Australia
T +61 2 9247 4144
F +61 2 9247 8157
www.uscom.com.au